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Receipt # �� � <br /> Date Faid _�� ' <br /> � Cost of Work Order $ _Z d/� Work order � �� <br /> Cost of Service order $ "ervice order I ` <br /> c- # � <br /> Requested Sy; �� �� / L S �� � Date of Request S-//-�"/ � <br /> Property owner (name) _ ��i� � 5 f � <br /> Charge Cost to (name if different than owner� / �3 ( `��„� �c .� r <br /> Address ��y7` ��3� �"'`K� <br /> City �U e Y-� � Zip _�Z a / � <br /> Installation Location __ ��3 Q �'Gl�J^i h .¢ D r� d�. <br /> Installation type/description/size/etc. <br /> .> v� Fi� e `i iia�r.��-i T <br /> � S � f � .4 5T' <br /> The following estimate is based upon the Utilities Division providing <br /> all labor, equipment, materials, restoration, and final hook-up. A <br /> double checl; valve assembly for temporary service is available from the <br /> City�s Permit Counter by requesting a Hydrant Use Permit with an <br /> additional deposit. <br /> Whenever the estimated cost is not sufficient to cover the total expense <br /> for labor, material, equipment rental and administrative costs, the <br /> deficit shall be charged to the property for which such installation was <br /> made and the owner thereof, and provided further, �hat any excess <br /> payment shall be returned to the person applying for the installation. <br /> Itemized Cost Estimate: <br /> Labor & Overhead �_ ! <br /> cc: Susy Haugen <br /> Material � Tom Thetford <br /> Don Weitkamp <br /> Equipment Rental � 7,� �arry Crawford <br /> Clair olivers <br /> Surface Restoration /d'a <br /> Service Order Cost �Gy S/a�d-q <br /> Total o ,✓s /�( '� <br /> Prepared by � „/D <br /> �7 <br />